Volume : 08, Issue : 01, January – 2021
125.MECHANICAL IMPACT OF AIRWAY HUMIDIFICATION DEVICES IN DIFFICULT TO WEAN PATIENTS
Dr Tayyaba Roshni, Dr Asad ur Rehman, Dr Hina Lodhi
Aim: To evaluate the impact of airway humidification devices on the effectiveness of ventilation in difficult to wean patients.
Study Design: This prospective, randomized, controlled study was conducted in a 22-bed intensive care unit at the Central ICU in collaboration with the Pharmacology department of Nishtar Hospital Multan for six-months duration from July 2020 to December 2020.
Interventions: 22-bed intensive care unit Patients with chronic respiratory failure were included. The effects of a heated humidifier and heat and moisture exchanger on diaphragm muscle activity, breathing pattern, gas exchange, and breathing comfort were assessed when disconnected from mechanical ventilation using supportive ventilation. Eleven patients with chronic respiratory failure received four consecutive pressure support ventilations at two different levels of pressure support ventilation (7 and 15 cm H2O) using a heated humidifier and a heat and moisture exchanger.
Results: Compared to the heated humidifier and regardless of the level of pressure assisted ventilation applied, the heat and moisture exchanger significantly increased all the inspiratory effort variables (inspiratory work of the breath expressed in J / L and J / min, pressure-time product, esophageal pressure and changes diaphragm pressure; p <0.05) and dynamic internal positive end-expiratory pressure (p <0.05). Similarly, the heat-moisture exchanger caused a significant increase in PaCO2 (p <0.01) responsible for severe respiratory acidosis (p <0.05), which was poorly compensated for despite a significant increase in minute ventilation (p <0.05). 05). This resulted in respiratory failure in all patients with heat and moisture exchangers (p <0.01). The negative effects were partially mitigated by increasing the level of pressure assisted ventilation by> 8 cm H2O using a heat-moisture exchanger.
Conclusions: The type of respiratory humidifier used may adversely affect the mechanical efficiency of ventilation and the use of a heat exchanger should not be recommended, unless the level of pressure support ventilation increases significantly. and moisture in patients requiring or potentially difficult to wean. chronic respiratory failure. (Crit Care Med 2003; 31: 1306-1311)
Keywords: heat and moisture exchanger; heated humidifier; respiratory work; pressure assisted ventilation; weaning
Cite This Article:
Please cite this article in press Tayyaba Roshni et al, Mechanical Impact Of Airway Humidification Devices In Difficult To Wean Patients., Indo Am. J. P. Sci, 2021; 08(1)..
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